ICU医疗器械相关性压疮的原因分析及对策  

Causes and solution of medical-devices-related pressure ulcer in intensive care unit

作　　者：刘亚红[1] 李婷[1] 付成成[1] 周昕[2] 蒋琪霞[2] 

机构地区：[1]南京军区南京总医院神经内科,210002 [2]南京军区南京总医院门诊伤口护理中心,210002

出　　处：《中华现代护理杂志》2014年第11期1252-1254,共3页Chinese Journal of Modern Nursing

基　　金：2010年度南京总医院医院立项课题（2010M012）

摘　　要：目的：评估分析ICU发生医疗器械相关性压疮的原因，并提出对策。方法2011年4月-2012年4月对ICU收治的患者进行追踪调查，由伤口干预组5人每月对全院各ICU追踪调查，专人查阅相关护理记录，调查医疗器械相关性压疮的情况和可能的原因。结果共调查分析了2240例ICU患者，发现与医疗器械相关的压疮37例，发生率为1．65％。其中与机械通气装置压迫有关的压疮18例，占48．65％；与矫形固定装置压迫有关的压疮9例，占24．32％。造成压疮前3位的医疗器械是面罩及系带、矫正器和丁字鞋以及气管插管及固定带，按照压疮护理指南给予干预处理后，28例患者压疮愈合，愈合时间4～12 d，平均（6．33±3．67）d，6例死亡，3例自动出院。结论 ICU患者压疮以使用机械通气装置和矫形固定装置压迫为最多见原因，提示ICU患者预防医疗器械相关性压疮重点在于减除压迫和进行局部保护。Objective To evaluate the causes of medical-devices-related pressure ulcer in intensive care unit （ ICU） and to come up with the countermeasures .Methods Patients were recruited between April 2011 and April 2012.A team of five nurses was in charge with the data collection , consultation of the nursing record and investigation of the possible reasons of medical-devices-related pressure ulcer .Results Among a total of 2 240 ICU patients, thirty-seven patients （1.65%） had medical-devices-related pressure ulcer, within which eighteen （ 48.65%） pressure ulcer was related to mechanical ventilation device and nine （ 24.32%） pressure ulcer was because of the orthopedic fixation devices .Medical devices which induced to pressure ulcer in the first three were mask and strap , orthotics and t shoes , endotracheal intubation and fixed belt .After the intervention treatment was given according to the pressure ulcer care guidelines , twenty-eight patients was healed , with healing time 4-12 d, six cases died , and three cases was in automatic discharge .Conclusions The use of ventilation devices and orthopedic fixation are the major causes of pressure ulcer .The key point to prevent pressure ulcer is to decompress tissue and skin , and strengthen the care for pressing areas .

关 键 词：压疮 医疗器械 原因 对策 

分 类 号：R473[医药卫生—护理学]